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Effect of 8.4% sodium bicarbonate on raised intracranial pressure after traumatic brain injury
© BioMed Central Ltd. 2010
Published: 1 March 2010
The aim of this study was to determine the efficacy of 8.4% sodium bicarbonate for intracranial pressure (ICP) reduction in adult patients with severe traumatic brain injury (TBI) and intracranial hypertension.
The study examined 10 episodes of ICP >20 mmHg in seven patients with severe TBI. Eighty-five milliliters of 8.4% sodium bicarbonate was infused over 30 minutes when osmotherapy was indicated after standard care. ICP, mean arterial pressure (MAP), and cerebral perfusion pressure (CPP) were recorded at baseline and then continuously for 6 hours. Serum pH, pCO2, (Na+), and (Cl-) were measured at baseline, 30 minutes, 60 minutes and then hourly for 6 hours. Serum osmolality was measured at baseline and at 6 hours in three patients. All other care was identical to the institutional protocol for the management of raised ICP.
Eighty-five milliliters of 8.4% sodium bicarbonate infused over 30 minutes is effective at reducing sustained ICP >20 mmHg to within accepted treatment targets (ICP <20 mmHg) for at least 6 hours.